Use of high-flow nasal cannula and noninvasive ventilation in patients with COVID-19: A multicenter observational study - 29/07/21
, Baixu Chen b, 1, Xiaoyi Liu c, 1, Weiwei Shu d, Wei Zhao e, Ji Li f, Yishi Li a, Yueling Hong a, Longfang Pan a, Ke Wang g, ⁎⁎
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Abstract |
Background |
The use of high-flow nasal cannula (HFNC) and noninvasive ventilation (NIV) in patients with COVID-19 is debated.
Methods |
This study was performed in four hospitals of China from January to March 2020. We retrospectively enrolled 23 and 13 COVID-19 patients who used HFNC and NIV as first-line therapy, respectively.
Results |
Among the 23 patients who used HFNC as first-line therapy, 10 experienced HFNC failure and used NIV as rescue therapy. Among the 13 patients who used NIV as first-line therapy, one (8%) used HFNC as rescue therapy due to NIV intolerance. The duration of HFNC + NIV (median 7.1, IQR: 3.5–12.2 vs. 7.3, IQR: 5.3–10.0 days), intubation rate (17% vs. 15%) and mortality (4% vs. 8%) did not differ between patients who used HFNC and NIV as first-line therapy. In total cohorts, 6 (17%) patients received intubation. Time from initiation of HFNC or NIV to intubation was 8.4 days (IQR: 4.4–18.5). And the time from initiation of HFNC or NIV to termination in patients without intubation was 7.1 days (IQR: 3.9–10.3). Among all the patients, C-reactive protein was independently associated with intubation (OR = 1.04, 95% CI: 1.01–1.07). In addition, no medical staff got nosocomial infection who participated in HFNC and NIV management.
Conclusions |
In critically ill patients with COVID-19 who used HFNC and NIV as first-line therapy, the duration of HFNC + NIV, intubation rate and mortality did not differ between two groups. And no medical staff got nosocomial infection during this study.
Le texte complet de cet article est disponible en PDF.Highlights |
• | The duration of HFNC + NIV, intubation rate and mortality did not differ between patients who initially used HFNC and NIV. |
• | C-reactive protein was independently associated with intubation among the patients who initially used HFNC or NIV. |
• | No medical staff got nosocomial infection during the management of COVID-19 patients who used HFNC and NIV. |
Keywords : COVID-19, High-flow nasal cannula, Noninvasive ventilation, Intubation
Plan
Vol 46
P. 276-281 - août 2021 Retour au numéro
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